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12th Annual Spine Summit in Seattle The Value of Spine Care - Fact and Fiction: A Clinical and Business Perspective Friday, October 25, 2013 Fairmont Olympic Hotel 411 University Street Seattle, WA 98101 Saturday, October 26, 2013 Harborview Medical Center Research & Training Building Auditorium 300 9th Avenue Seattle, WA 98104 Sponsored by the University of Washington School of Medicine Departments of Orthopaedics & and Neurological Surgery Office of Continuing Medical Education

12th Annual Spine Summit in Seattle October 25-26, 2013 WHO SHOULD ATTEND This conference is designed for spine surgeons, orthopaedic surgeons and neurological surgeons with interest in spinal care, physiatrists/rehabilitation medicine specialists, pain management specialists, anesthesiologists otherwise involved in spine care, neuroradiologists, primary care and family medicine providers with exposure to larger spine care patient populations, mid-level providers (physician assistants, nurse practitioners involved in spine care) and physical therapists and occupational therapists. COURSE DESCRIPTION This marks the 12th consecutive year in which a fall symposium at Harborview Medical Center has been held, pertaining to Spine Surgery. For the participants this intense meeting offers the unique chance to learn in a number of ways: small group case discussions, plenary debates and lectures on current major clinical care concerns and advanced research as well as hands-on surgical cadaver labs delivered by acknowledged leaders in a time efficient and highly engaging format. This meeting has evolved from an annual surgical practice lab over ten years ago to a major recognized symposium. COURSE OBJECTIVES Upon completion of this activity, attendees should be able to: Describe the many financial, medical and societal variables that contribute to determining value in the delivery of spine care Discuss how money dedicated to the treatment of spine conditions is spent Explain the origin and validity of current insurance company standards for approving operative intervention in intervertebral disc conditions Discuss the role of registries that tract results of treatment in the process of establishing value of spine care Recognize the role of early surgery in reducing the burden to society of spine trauma with neurological deficits Recognize the value of newer technologies, such as minimally invasive spine surgery and disc replacement surgery Explain how various factors such as comorbidities and insurance status affect outcomes and cost in the treatment of spine conditions Discuss the research possibilities for further determining the value (or lack thereof) in the treatment of spine conditions ACCREDITATION Accreditation with Commendation The University of Washington School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Credit Designation The University of Washington School of Medicine designates this live activity for a maximum of 10.25 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. MD/DO/PhD $155.00 Allied Health $115.00 Resident/Fellow $ 75.00 FEES AND REGISTRATION The fee for this course includes catering, all instruction materials and transcript of AMA PRA Category 1 Credits. To ensure enrollment, please complete the enclosed registration form and forward it with the appropriate tuition. Allow up to fifteen working days to receive your email confirmation of enrollment. If you have not received confirmation prior to your departure for the course, please contact the Continuing Medical Education office at 206.543.1050. Continuing Medical Education will not be responsible for expenses incurred by an individual who is not confirmed and for whom space is not available at the course.

CONFERENCE SYLLABUS IS GOING GREEN Syllabus materials will be available for download at uwcme.org (for conference registrants only). The password for the download website will be sent with your registration confirmation email. Materials will be available from October 21 - November 22, 2013, for registrants to print and/or download. A booklet with the conference agenda and pages for note-taking will be provided at the conference. ATTENDANCE POLICY Course activities are exclusively reserved for course attendees. Badges provided at registration are required for entrance into all functions and will be strictly enforced. CANCELLATION POLICY The Office of Continuing Medical Education must receive written notification of your cancellation by October 15, 2013. A $50.00 processing fee will be deducted from refund requests received by this date. No refunds will be issued following October 15, 2013. The Office of Continuing Medical Education reserves the right to cancel this course twenty (20) days prior to the course date when a minimum enrollment is not met or for other reasons that prevent the University from holding the course. Each registrant will be notified by telephone followed by written notification and a full refund. The University of Washington is not responsible for any other costs incurred such as non-refundable airline tickets or hotel penalties. Contact CME Registrar with questions call 206.543.1050, fax 206.221.4525 or email cme@uw.edu. SPECIAL SERVICES Continuing Medical Education at the University of Washington is a totally self-sustaining unit and does not depend on or receive public monies in support of its educational efforts. Fees for this course are estimated to cover the costs of conducting this course. These costs include salaries, registration and credit, handouts, record keeping, faculty planning and evaluation and may include food, alcohol, taxes and gratuities to vendors. The University of Washington reaffirms its policy of equal opportunity regardless of race, color, creed, religion, national origin, sex, sexual orientation, age, marital status, disability, or status as a disabled veteran or Vietnam era veteran in accordance with University policy and applicable federal and state statutes and regulations. The University of Washington is committed to providing access and reasonable accommodation in its services, programs, activities, education and employment for individuals with disabilities. To request disability accommodation in the application process contact the department at: 206.543.1050 or the Disability Services Office at least ten days in advance. Contact Disability Services Office 206.543.6450/Voice 206.543.6452/TTY 206.685.7264/Fax e-mail: dso@u.washington.edu HOTEL ACCOMMODATIONS The University of Washington has contracted for special rates at the Fairmont Olympic Hotel in Seattle. You must mention Spine Summit in Seattle to receive the special rate. The rates quoted below do not include applicable taxes. Please make your reservation early. After October 4, 2013, these rates and accommodations may no longer be available. The University of Washington accepts no further responsibility for lodging. Fairmont Olympic Hotel Single/Double 411 University Street $209.00 Seattle, WA 98101 For reservations call: 206-621-1700 x3131 www.fairmont.com/seattle

Course Faculty Carlo Bellabarba, MD Professor Departments of Neurological Surgery and Orthopaedics & COURSE CO-CHAIRS Associate Professor Departments of Neurological Surgery and Orthopaedics & Oheneba Boachie-Adjei, MD Professor, Department of Orthopaedic Surgery Weill Cornell Medical College Chief, Scoliosis Service Hospital for Special Surgery New York, NY Joseph S. Cheng, MD, MS Associate Professor of Neurological Surgery Director, Neurosurgery Spine Program Vanderbilt University Medical Center Nashville, TN GUEST FACULTY Jack E. Zigler, MD, FACS, FAAOS Medical Director, Texas Back Institute Former Clinical Professor of Orthopaedic Surgery University of Southern California School of Medicine Los Angeles, CA Richard J. Bransford, MD Associate Professor Jens R. Chapman, MD Professor and Chair David R. Flum, MD, MPH Professor Department of Surgery UW FACULTY Michael J. Lee, MD Associate Professor Christopher J. Standaert, MD Clinical Professor Theodore A. Wagner, MD Clinical Professor

FRIDAY, OCTOBER 25, 2013 Location: The Fairmont Olympic Hotel 6:00 Hosted Reception and Dinner 6:00-9:00 pm 7:00 Case Presentations - An Evening with Spine Experts: How Do You Handle This? Moderators: Carlo Bellabarba, MD & Visting Faculty: Oheneba Boachie-Adjei, MD; Joseph Cheng, MD, MS; Jack Zigler, MD 9:00 Adjourn SATURDAY, OCTOBER 26, 2013 Location: Harborview Medical Center Research and Training Building 6:30 Registration and Continental Breakfast 7:00 Welcome and Introduction Carlo Bellabarba, MD & The Challenge of Defining Cost and Value Moderator: Carlo Bellabarba, MD 7:05 How is the Value of Treatment Determined? Carlo Bellabarba, MD 7:15 Rating the Raters: The Validity of Insurance Company Standards for Authorizing Procedures Joseph Cheng, MD, MS 7:30 The Value of Disc Replacement and Fusion Surgery Jack Zigler, MD, FACS, FAAOS 8:00 The Value of Minimally Invasive Surgery 8:30 Discussion 8:45 What is a Spine Surgeon Worth to the Hospital and to the Insurance Company? Joseph Cheng, MD, MS 9:15 What is the Cost of a 1 Hour Delay in Surgery? The UWMC Experience Theodore Wagner, MD 9:30 Discussion 9:40 Break Determining Cost and Value of Current Treatment Approaches Moderator: Michael Lee, MD 10:00 The Cost of Treating Spine Conditions: Where Does the Money Go? Joseph Cheng, MD, MS

SATURDAY, OCTOBER 26, 2013 (...continued) 10:15 The Role of Washington State Spine SCOAP Registry Data in Determining the Value of Spine Care Michael Lee, MD 10:30 The Influence of Comorbidities and Patient Demographics on Outcomes (and Value) of Spine Treatment Michael Lee, MD 10:50 Cost and Value of Nonoperative Treatment for Spine Conditions Christopher Standaert, MD 11:05 Total Disc Replacement Surgery - Lessons Learned Jack Zigler, MD, FACS, FAAOS 11:35 Discussion 11:45 Lunch (provided) - Case Reviews Theodore Wagner, MD and Faculty Determining Cost & Value of Treating Specific Spine Conditions Moderator: Jens Chapman, MD 12:45 Bringing Complex Spine Deformity Surgery to Developing Countries - Dream or Reality Oheneba Boachie-Adjei, MD 1:05 The Influence of Early Surgery on the Value of Spine Trauma Care Richard Bransford, MD 1:20 The Value of Surgical Treatment for Radiculopathy 1:35 The Value of Surgical Treatment for Cervical Myelopathy Jens Chapman, MD 1:50 Discussion 2:00 Break (travel to ISIS Lab or to SCOAP Workshop) 2:15-5:00 ISIS Surgical Labs (optional) Station 1 Disc Arthroplasty - Cervical & Lumbar Richard Bransford, MD & Jack Zigler, MD, FACS, FAAOS Station 2 Deformity Theodore Wagner, MD & Oheneba Boachie-Adjei, MD Station 3 Minimally Invasive Surgery with Navigation Station 4 Minimally Invasive Surgery with C-Arm 2:15-5:00 SCOAP MEETING - Annual Update (optional) Michael Lee, MD & David Flum, MD, MPH 5:00 Adjourn

12th Annual Spine Summit in Seattle October 25-26, 2013 REGISTRATION First MI Last Professional Title MD DO PhD ARNP RN PA Other: Street City State Zip Phone ( ) - Email PAYMENT *Residency Program, if applicable Check (payable to University of Washington) for $ Credit Card charge $ Visa MC Discover Card # Exp Date Signature UW Budget Budget Name Budget # Box # Proj Opt Task Register online at uwcme.org COURSE FEES MD/DO/PhD $155.00 Allied Health $115.00 Resident*/Fellow $ 75.00 Return Completed Registrations BY MAIL: UWCME Box 359441 Seattle, WA 98195-9441 BY FAX: 206.221.4525 CALL: 206.543.1050 with questions MJ1405